North Dakota Protection & Advocacy Project

Current Priorities & Resources: Agency Priorities: Abuse & Neglect

In 1975, after becoming aware of the inhumane conditions at Willowbrook, a New York State institution for persons
with developmental disabilities, Congress recognized that a federally-directed system of legal advocacy was necessary
to address the abuse and neglect of persons with mental retardation and other developmental disabilities and
established a nation-wide protection and advocacy system. In following years, Congress recognized the same concerns
existed for people with mental illness and other types of disabilities and expanded the authority of the federally-
established protection and advocacy system.

While great progress was made in addressing concerns and the work of the protection and advocacy system has expanded
to include other issues, studies conducted in the late 1990's led the Centers for Medicare and Medicaid Services
(CMS), the Office of Inspector General (OIG), and the Government Accounting Office (GAO) to conclude that abuse and
neglect of vulnerable Americans continued to be a major health care concern.

Today, we continue to read stories in the national media exposing cases of abuse and neglect that result in illness, death, and torture of people with disabilities. Nation-wide, the protection and advocacy system has processed thousands of complaints of abuse and neglect of people with developmental disabilities and mental illness.

In North Dakota, P&A has primary responsibility to address complaints of abuse and neglect of people with developmental disabilities and mental illness. In fiscal year 2011, P&A processed 1600 complaints of abuse and neglect. P&A responds to complaints with information, referrals, investigations, facility monitoring, and protective services. P&A also works proactively to train service provider staff and individuals with disabilities to recognize and report incidents of abuse and neglect.

P&A collaborates and works closely with Child Protective Services, Vulnerable Adult Protective Services, the
Long Term Care Ombudsman, and others to ensure that all abuse and neglect complaints of people with disabilities are
appropriately addressed. A variety of factors can increase the vulnerability of people with disabilities. They
include:

Dependence on others for basic needs, such as bathing, using the toilet, meal preparation, etc. Individuals may
also need help with money management, transportation, and obtaining medical and dental care. This reliance on others to
assist with activities of daily living increases a person's vulnerability and exposure to abuse and neglect.

Socialization to comply with the instructions of "those in charge," whether they are professionals,
in-home workers, volunteers or family members. If the "person in charge" is physically or sexually abusive or
neglectful, this learned compliance undermines the person's power to seek protection or support.

Living in group or institutional settings. It is important for staff at these facilities to receive adequate
training in the care and treatment of individuals with disabilities, as well as information on recognizing and
reporting abuse and neglect. Facilities also need to provide enough supervision that incidents of physical or sexual
abuse do not occur.

Historically, people with disabilities have been discriminated against because of their disabilities, seen as
incapable and helpless, separated from society-at-large and denied opportunities for education and other life
experiences. Misperceptions and stereotypes about people with disabilities also put people with disabilities at an
increased risk to experience abuse and neglect.